PTSD Symptoms Put Women at Greater Risk for Type 2 Diabetes

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New evidence points to a strong connection between post-traumatic stress disorder and type 2 diabetes in women.

According to a new study published in JAMA Psychiatry,
women with multiple post-traumatic
stress disorder (PTSD)
symptoms are nearly twice as likely to develop type 2 diabetes as women without PTSD.

It’s the strongest indication yet of a possible causal
relationship, or cause and effect, between PTSD and type 2 diabetes, said
researchers from Columbia University’s Mailman School of Public Health in New
York.

Our mental health affects our physical health. Disorders like PTSD that often begin in a woman’s teens or twenties have negative physical consequences for their whole lives.

Karestan Koenen, Mailman School of Public Health, Columbia University

“Our mental health affects our physical health. Disorders like
PTSD that often begin in a woman’s teens or twenties have negative physical
consequences for their whole lives,” said Karestan Koenen, Ph.D., a senior
author of the study and a professor of epidemiology at the Mailman School.
“Perhaps earlier treatment of the mental disorders can prevent some of the
physical disorders.”

Researchers analyzed 22 years of data collected from 49,739 women
in the Nurses Health Study II. The study is a national, long- term
investigation of the health of women who were between the ages of 24 and 42
when the study began in 1989.

The researchers found that PTSD and type 2 diabetes have what’s
known as a dose-response relationship. This means that the likelihood and
severity of type 2 diabetes is related to the amount and condition of exposure
to PTSD.

Diabetes Risk Increases with More PTSD Symptoms

The risk of type 2 diabetes increased with more reported PTSD symptoms,
according to the researchers. What’s more, by the time women reached age 60, nearly
12 percent of those with the highest number of PTSD symptoms had developed type
2 diabetes. Among those with no reported trauma, less than 7 percent had the
disease.

Participants were asked questions about trauma history, PTSD
symptoms, and any later diabetes diagnosis. Lifestyle factors, including
alcohol intake, smoking, antidepressant use, body mass index, diet quality, and
physical activity level were also taken into account. Diagnoses were then
independently confirmed through medical records.

Antidepressant use and elevated body mass index (a measure of body
fat) were linked to nearly half of the increased risk of type 2 diabetes. None
of the other lifestyle issues researchers studied impacted the link between the
two conditions.

“It was surprising how important antidepressant use was. We didn’t
expect this and are trying to understand it better, especially considering how
widely prescribed antidepressants are,” said Koenen.

The most common kinds of trauma reported were child abuse and
interpersonal violence, which includes rape, sexual assault, and partner
violence. “It’s similar to what is seen in the general population. These are
women you would know in the community,” Koenen explained.

High Risk Populations, Minority Groups Need PTSD Screening

It’s important for women and their doctors to know that PTSD
and trauma have profound effects on physical health, not just mental health.
They can’t be seen as separate problems, Koenen stressed. She said that about
50 percent of Americans with PTSD do not receive treatment. This is especially
true among minority groups.

“So it’s critically important to improve access to mental health
care in the United States and provide more access and equity to treatment.
Primary care providers need to be screening for PTSD among high-risk
populations,” she said.

Koenen said there are
effective, relatively short-term treatments available for women with PTSD. The Anxiety and Depression Association of
America provides hotlines to get people directly connected to treatment.
Sliding fee scales are usually available.

Unfortunately, many symptoms of the disorder can get in the way of
women taking care of their physical health, Koenen explained. “They might avoid
certain locations or people. That can get in the way of exercising, socializing,
and eating well,” she said.

“I was always struck by how many chronic diseases women with PTSD
experienced, especially conditions like cardiovascular disease, obesity, and
diabetes, which we know are huge public health problems,” Koenen added.

Although this study focused only on women with PTSD, Koenen said
the data is consistent with studies conducted by the military on all or mostly
male groups.